Associations between body mass index, weight loss and overall survival in patients with advanced lung cancer

Oswalt, Cameron J.; Liu, Yingzhou; Pang, Herbert; Le‐Rademacher, Jennifer; Wang, Xiaofei; Crawford, Jeffrey

doi:10.1002/jcsm.13095

Cited by 17 publications

(19 citation statements)

References 31 publications

(54 reference statements)

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“…Subsequent internal validation cohorts demonstrated that the IBI is a simple, effective, reproducible biomarker for the prognostic assessment of patients with NSCLC. Weight loss is an important factor in the assessment of cachexia and prognostic evaluation of patients with cancer 25 . However, the clinical assessment of weight loss depends mainly on self‐reporting of cancer patients, and weight loss data are often lacking clinically.…”

Section: Discussionmentioning

confidence: 99%

“…CRP is not only a marker of inflammation but also has many key pro‐inflammatory properties. CRP can induce the initiation of endothelial and smooth muscle cells and promote the expression of adhesion molecules, chemoattractants and vascular endothelial growth factor, which are essential for tumour invasion 25,26 . In addition, some studies have found that CRP can directly affect the function of immune active cells, thereby affecting the body's cytotoxic immune response and promoting tumour immune escape 27,28 .…”

Section: Discussionmentioning

confidence: 99%

“…Weight loss is an important factor in the assessment of cachexia and prognostic evaluation of patients with cancer. 25 However, the clinical assessment of weight loss depends mainly on self‐reporting of cancer patients, and weight loss data are often lacking clinically. In this study, we found that IBI was independently associated with 90‐day outcomes and cachexia in patients with NSCLC, which indicated that IBI can be used as an objective and effective tool for cancer cachexia in addition to weight loss.…”

Section: Discussionmentioning

confidence: 99%

Section: Utility Of the Ibi As A Biomarkermentioning

confidence: 99%

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The inflammatory burden index is a superior systemic inflammation biomarker for the prognosis of non‐small cell lung cancer

Xie

Ruan

Wei

et al. 2023

J cachexia sarcopenia muscle

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Background Systemic inflammation, the most representative tumour–host interaction, plays a crucial role in disease progression and prognosis in patients with non‐small cell lung cancer (NSCLC). Few studies have compared the performance of existing haematological systemic inflammation biomarkers in predicting the prognosis of NSCLC patients. The purpose of this study was to compare the prognostic value of existing systemic inflammation biomarkers and determine the optimal systemic inflammation biomarker in patients with NSCLC through a multicentre prospective study. Methods The predictive accuracy of systemic inflammation biomarkers for prognostic assessment in NSCLC was assessed using C‐statistics. Inter‐group differences in survival were assessed using the log‐rank test and visualized using the Kaplan–Meier method. A restricted cubic spline (RCS) curve was used to explore the association between the biomarkers and survival. Independent prognostic biomarkers for overall survival were determined using multivariable Cox proportional hazards regression analysis. Logistic regression analysis was used to determine independent predictors of 90‐day outcomes, length of hospitalization, hospitalization expenses and cachexia. Results The inflammatory burden index (IBI) had the highest C‐statistic for predicting the prognosis of patients with NSCLC, reaching 0.640 (0.617, 0.663). Patients with a high IBI had significantly worse outcomes than those with a low IBI (35.46% vs. 57.22%; log‐rank P < 0.001). The IBI was also able to differentiate the prognosis of patients with NSCLC with the same pathological stage. The RCS curve showed an inverted L‐shaped dose–response relationship between the IBI and survival of patients with NSCLC. Multivariable Cox proportional hazards regression analysis showed that a high IBI was an independent risk factor for death of patients with NSCLC (hazard ratio = 1.229, 95% confidence interval [CI]: 1.131–1.335, P < 0.001). A high IBI was an independent predictor of 90‐day outcomes (odds ratio [OR] = 1.789, 95% CI: 1.489–2.151, P < 0.001), prolonged hospital stays (OR = 1.560, 95% CI: 1.256–1.938, P < 0.001), high hospitalization expenses (OR = 1.476, 95% CI: 1.195–1.822, P < 0.001) and cachexia (OR = 1.741, 95%CI = 1.374–2.207, P < 0.001) in patients with NSCLC. Conclusions The IBI was independently associated with overall survival, 90‐day outcomes, length of hospitalization, hospitalization expenses and cachexia in NSCLC patients. As an optimal systemic inflammation biomarker, the IBI has broad clinical application prospects in predicting the prognosis of patients with NSCLC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Utility Of the Ibi As A Biomarkermentioning

confidence: 99%

See 2 more Smart Citations

The inflammatory burden index is a superior systemic inflammation biomarker for the prognosis of non‐small cell lung cancer

Xie

Ruan

Wei

et al. 2023

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

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“…Extensive investigations on this topic have been conducted in large cohorts after adjusting potential confounders such as smoking and race. Several studies also included additional details to categorize obesity, for example, using BMI trajectories and metabolic obesity as phenotype (1)(2)(3)(4)(5)(6). Although the effect of obesity on small cell lung cancer and lung squamous cell carcinoma (LUSC) remains inconclusive, a consistent inverse effect of obesity on lung adenocarcinoma (LUAD) were observed across studies, especially for those patients receiving immune checkpoint inhibitor treatments.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Obesity-associated Long Noncoding RNAs in Lung

Fu¹,

Huang

Lin³

et al. 2023

Preprint

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Obesity often increases the risk of cancer and worsens the prognosis. Unlike most types of cancer, several studies concluded that obesity had an inverse influence on LUAD survival. Increasing evidence showed that obesity-related and adipocyte-derived lncRNAs were associated with cancer initiation, progression, drug resistance, and the tumor microenvironment in lung cancer. In the present study, we identified two BMI-associated lncRNAs (LINC01500 and lnc-MAFB-1) that could potentially regulate tumor progression in LUAD. Both lncRNAs downregulated significantly in the obese lung. The increased expression level of LINC01500 could be observed in LUAD tumors and predict poorer survival. In addition, through estimation from bulk RNA-seq and profiling in single-cell sequencing, we found that the expressions of both BMI-associated lncRNAs were associated with macrophages. The downregulation of BMI-associated lncRNAs could create a less immunosuppressive microenvironment, leading to a more efficient response toward immunotherapy. To our knowledge, this is the first study to investigate BMI-associated lncRNAs in lung. We believe our findings can expand the understanding of obesity and the immune microenvironment in lung cancer.

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Metformin as a booster or obstacle of immunotherapy in patients with non–small cell lung cancer and diabetes mellitus

Guan,

Ding,

Ning

et al. 2023

Cancer

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We read the article by Leshem et al. 1 with great interest. In a retrospective study, the authors estimated the impact of diabetes mellitus on the efficacy of pembrolizumab in patients with metastatic non-small cell lung cancer (NSCLC). They demonstrated significantly shorter overall survival (OS) and progression-free survival (PFS) for patients with diabetes versus those without diabetes, and diabetes mellitus was identified as an independent risk factor for shorter PFS and OS. It followed that immunotherapy might be less beneficial for patients with metastatic NSCLC. Despite inspiring and thoughtprovoking findings, we would like to raise the following comments.First, demographic and clinical characteristics associated with NSCLC, such as age, comorbidities, and body mass index (BMI), were included in the study, as presented in the article's Table 1. However, significant differences between diabetic and nondiabetic groups existed in age, the presence of hypertension, BMI, and so on. As is known to all, lung cancer is an age-related disease. 2 Current evidence suggests that BMI is strongly associated with OS in patients with advanced NSCLC. 3,4 In other words, these confounding variables between diabetic and nondiabetic groups indicated an unbalanced background.

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Associations between body mass index, weight loss and overall survival in patients with advanced lung cancer

Cited by 17 publications

References 31 publications

The inflammatory burden index is a superior systemic inflammation biomarker for the prognosis of non‐small cell lung cancer

The inflammatory burden index is a superior systemic inflammation biomarker for the prognosis of non‐small cell lung cancer

Characterization of Obesity-associated Long Noncoding RNAs in Lung

Metformin as a booster or obstacle of immunotherapy in patients with non–small cell lung cancer and diabetes mellitus

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